Sobreira-Neto Manoel Alves, Pena-Pereira Márcio Alexandre, Sobreira Emmanuelle Silva Tavares, Chagas Marcos Hortes Nisihara, Almeida Carlos Maurício Oliveira de, Fernandes Regina Maria França, Tumas Vitor, Eckeli Alan Luiz
Universidade Federal do Ceará, Faculdade de Medicina, Departamento de Clínica Médica, Fortaleza CE, Brasil.
Universidade Unichristus, Fortaleza CE, Brasil.
Arq Neuropsiquiatr. 2019 Sep 23;77(9):609-616. doi: 10.1590/0004-282X20190098. eCollection 2019.
Obstructive sleep apnea (OSA) occurs in up to 66% of Parkinson's disease (PD) patients, higher than in the general population. Although it is more prevalent, the relationship between OSA and PD remains controversial, with some studies confirming and others denying the relationship of OSA with some risk factors and symptoms in patients with PD. OBJECTIVE To determine the factors associated with OSA in PD patients com DP. METHODS A cross-sectional study was performed with 88 consecutive patients with PD from the outpatient clinic. Participants underwent clinical interviews with neurologists and a psychiatrist, assessment using standardized scales (Epworth Sleepiness Scale, Parkinson's Disease Questionnaire, Pittsburgh Sleep Quality Index and, for individuals with a diagnosis of restless legs syndrome/Willis-Ekbom disease, the International Restless Legs Syndrome Rating Scale), and video-polysomnography. RESULTS Individuals with PD and OSA were older and had less insomnia than those with PD without OSA. Regarding the polysomnographic variables, we observed a lower percentage of stage N3 sleep, a higher arousal index, and a higher oxygen desaturation index in those individuals with OSA, relative to those without OSA. In the multivariate analysis, only the percentage of stage N3 sleep and the oxygen desaturation index were significantly different. Besides this, most of the PD patients with OSA had a correlation with sleeping in the supine position (58% of OSA individuals). CONCLUSION The PD patients showed a high prevalence of OSA, with the supine position exerting a significant influence on the OSA in these patients, and some factors that are associated with OSA in the general population did not seem to have a greater impact on PD patients.
阻塞性睡眠呼吸暂停(OSA)在高达66%的帕金森病(PD)患者中出现,高于普通人群。尽管其更为普遍,但OSA与PD之间的关系仍存在争议,一些研究证实而另一些研究否认OSA与PD患者的某些危险因素及症状之间的关系。目的:确定合并DP的PD患者中与OSA相关的因素。方法:对门诊连续88例PD患者进行横断面研究。参与者接受了神经科医生和精神科医生的临床访谈,使用标准化量表(爱泼华嗜睡量表、帕金森病问卷、匹兹堡睡眠质量指数,对于诊断为不宁腿综合征/Willis-Ekbom病的个体,使用国际不宁腿综合征评定量表)进行评估,并进行视频多导睡眠图检查。结果:与无OSA的PD患者相比,合并OSA的PD患者年龄更大且失眠更少。关于多导睡眠图变量,我们观察到,与无OSA的个体相比,合并OSA的个体N3期睡眠百分比更低、觉醒指数更高以及氧去饱和指数更高。在多变量分析中,只有N3期睡眠百分比和氧去饱和指数存在显著差异。除此之外,大多数合并OSA的PD患者与仰卧位睡眠有关(58%的OSA个体)。结论:PD患者中OSA的患病率较高,仰卧位对这些患者的OSA有显著影响,并且一些在普通人群中与OSA相关的因素似乎对PD患者影响不大。